The main application area is based inter alia on the field of radiology, in which computer-assisted RIS (Radiology Information System), HIS (Hospital Information System) and PACS (Picture Archiving and Communication system”) are conventionally used. The diagnosis is based on a medical imaging examination on different modalities, such as for instance a computed tomograph (CT), a magnetic resonance tomograph (MRT), a positron emission tomograph (PET), an x-ray device (x-ray) or an ultrasound device (US). The cited radiological examination devices provide the image data record. The image data record is generally an image volume data record, which contains a volume image, or an image series data record, which contains a series of images.
Image data records are created by way of modern imaging methods, such as for instance computed tomography (CT), magnetic resonance (MR) or ultrasound (US), the contents of which are so complex that a comprehensive and fault-free evaluation by way of radiologists is only possible with difficulty.
These imaging methods can generate very detailed and versatile data relating to patients on account of improved resolution or new examination protocols and methods. A large part of this data is nowadays quantitative in imaging diagnostics and can, such as for instance laboratory values, contribute to assessing the development of illnesses. At the same time, physicians are to present this abundance of data in a clear manner.
Current systems in most cases inadequately satisfy this requirement, since data from different imaging methods cannot be represented together or because the physician must consider individual preexaminations sequentially and/or must read the assigned textual diagnosis. To preserve an overview of an individual imaging study, it may pose a challenge if one considers that studies increasingly include a large number of individual images.
The evaluation of the image data records largely takes place in a computer-assisted fashion at diagnostic stations, which provide for observation and navigation through the image data record and a summary of the evaluation (for instance as text or dictation). The image data record is to this end stored in series of medical images, which a radiologist essentially observes sequentially, wherein he/she dictates the evaluation. In particular, the appearance, position and changes to pathological structures are described in the evaluation. The pathological structures are for instance tumors, but also vessels, bones etc. which feature a pathological deviation compared with a healthy normal state.
Before a radiologist currently starts with the diagnosis of medical images, he/she will, if available, firstly read the previous diagnosis of a patient and if applicable consider the associated image data. He/she herewith navigates, guided by the diagnosis text (e.g. “mass lesion in the 6th liver segment”, “fracture of the 7th rib, left”) in an image diagnosis software (e.g. PACS, DICOM Viewer, Advanced Visualization) to the described individual diagnoses. He/she subsequently diagnoses the current image data systematically, wherein his/her cognitive output consists in reaching a coherent clinical picture and thus a diagnosis from numerous pathological changes and abnormalities. Both the individual image diagnosis (pathological abnormalities, often extended by measurements of tumor sizes and degrees of stenosis) and also the summarized evaluation are subsequently verbalized in the form of a radiological examination report and forwarded to the treating physician for instance.
More recent software for image diagnosis facilities the physician with navigation in terms of individual image diagnosis, by these usually being shown in the form of a list and by selecting an individual diagnosis, directly representing the corresponding images in a form suited to representing the individual diagnosis. A qualitative graphic visualization of diagnoses is possible for specific medical diagnosis procedures. This is however specific and does not allow for a uniform and at the same time flexible visualization of the diagnoses throughout all diagnosis procedures.
Modern software for image diagnosis also enables the simultaneous representation of several image data records (adjacent to one another or superimposed). The image data records can herewith also originate from different imaging methods. Registration of the image data records herewith enables individual image diagnoses to be compared longitudinally or observed in extended representations (e.g. anatomical details by means of CT, functional information by means of MR, metabolic information by way of PET).
Aside from the cognitive output already mentioned above, which has to adduce the radiologist to a coherent clinical picture and/or diagnosis when combining numerous individual diagnoses (possibly from different sources), a further mental stress on the radiologist resides in him/her permanently switching between different types of information representation. Even if the relevant individual image diagnoses are collected within the image diagnosis software at a central point in the form of a list, the radiologist must consequently switch between a verbal representation of a diagnosis and its visual representation. The same problem results in turn on the part of the referring physician. These have to read, and for their part interpret, the information collected in the examination report using different types of information representation in order to obtain an informed understanding of the overall clinical picture.